Local Option

The Senate legislation would prohibit health insurers who provide a prescription drug benefit from "mandating" insured's receive their prescriptions via mail-order. The Assembly legislation further adds that insurers are prohibited from imposing unfair co-payments on consumers who prefer to use their community-based pharmacy.

Pharmacy Benefit Managers (PBMs) aggressively move their clients into mail-order pharmacy services by either "prohibiting" consumers from getting their prescriptions filled at their community pharmacy or by imposing economic disincentives that steer consumers to their subsidiary mail order pharmacy operations. These self-serving business practices have led to several well-documented court cases charging PBMs with fleecing their clients by inflating the prices and hiding the rebate revenues.

New York State loses hundreds of millions of dollars each year as taxpayer supported prescription drug plans "mandate" mail-order prescription drug services, while tax paying, job creating community pharmacies are not allowed to compete. PBMs simply write the local pharmacy out of their plans, shift volume to themselves and continue to call this "cost-containment."

New York's consumers are the big losers here as study after study has demonstrated that face-to-face consultations between consumers and their pharmacist save healthcare dollars by reducing other healthcare costs and enhancing a patient's quality of life.